Physical exercise for prevention of dementia study: a 48-month randomized controlled trial.

Background: Although multimodal exercise interventions are recognized for their potential to attenuate age-related cognitive decline, the current literature lacks longitudinal depth. Specifically, robust randomized evidence addressing the long-term efficacy of structured training protocols remains limited. This single-blind RCT involved 882 community-dwelling older adults categorized as healthy, having subjective memory complaints (SMCs), or having mild cognitive impairment (MCI). Methods: Participants were randomized to an experimental group (EG), performing 48 months of supervised moderate-to-high-intensity multimodal training (aerobic, resistance, and stretching), or to a control group (CG), maintaining usual habits. The primary outcome was the 48-month change in Mini-Mental State Examination (MMSE) scores. Secondary outcomes were scores on eight neuropsychological tests assessed at 12, 24, 36, and 48 months. A linear mixed-effects model analysis with repeated measures (LMM) was used to evaluate significant differences between the CG and EG. Results: In the final analysis of 674 participants, healthy participants (between-group effect: Conclusion: A 48-month multicomponent exercise program significantly improved cognitive performance in healthy and SMC older adults. Structured physical activity may effectively slow cognitive decline. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT02236416. Identifier number: NCT02236416.